Sore and sometimes painful nipples are so common at the start of breastfeeding that you can almost expect some level of discomfort. That said, the pain can be a sign of other conditions, and can worsen if not addressed. It’s important to pay attention to your symptoms and figure out what may be causing them.

What it is

At any point during your breastfeeding journey, but especially at its beginning, it is common to feel tender and sore on and around your nipples. Regardless of when the soreness occurs, there are a few things you can do to relieve it. Track your symptoms closely, as more serious conditions can quickly develop.

When it can occur

While your nipples can become sore at any point during your breastfeeding (and/or pumping) journey, they typically are most vulnerable to soreness in the first days and weeks following delivery.

What causes it

Your nipples may become sore for a variety of reasons. Leading causes include an ill-fitting pump flange (or suction) and an improper latch. Another common culprit: a baby’s short frenulum, which is the tissue connecting the tongue to the bottom of the mouth. Your baby might also be sucking excessively for comfort (rather than just milk), or just sucking harder than normal for milk, potentially to compensate for improper latch positioning, a slow let-down reflex, or inverted nipples.

What to do

If your nipples feel tender and painful when your baby latches on for a feed, and they don’t feel better after about 10 seconds into a feeding session, try to reset the latch by gently inserting a clean finger into the corner of your baby’s mouth to break the suction, and look at your nipple. A round and long nipple indicates a proper latch; a flattened or compressed nipple (like the angle of a lipstick tube) indicates an improper latch. 

You can relieve symptoms by working on improving your baby’s latch, trying different breastfeeding positions, and/or pumping. 

Pumping should never be painful, so if your nipples are sore during or after pumping, you should try a different pump flange size (for Go or 360), insert, or suction level. 

For extra relief after you nurse or pump, you can express some of your breast milk and gently rub it on your nipples. You can also try nipple balm to help soothe tired and sore nipples.

When to get help

Contact your provider or a lactation consultant, if you’re in too much pain to continue breastfeeding or pumping, or if you suddenly have new pain or changes in breast shape or skin texture. These could be signs of an infection or hormonal-influenced skin conditions. Specifically, look out for:

• cold or wet nipples that change from white to pink
• a burning pain during or after nursing with shiny, flaky red skin
• white patches on your baby’s tongue and inside cheeks that indicate thrush